Provider Demographics
NPI:1184658452
Name:HATCH, RICHARD HENRY (OD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HENRY
Last Name:HATCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-8522
Mailing Address - Country:US
Mailing Address - Phone:336-578-4544
Mailing Address - Fax:336-578-4544
Practice Address - Street 1:2150 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-8522
Practice Address - Country:US
Practice Address - Phone:336-578-4544
Practice Address - Fax:336-578-4544
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0734152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909384Medicaid
NC0366180001Medicare NSC
NC0366180016Medicare NSC
NC246335DMedicare PIN
T64877Medicare UPIN